Smart metrics, slow thinking, off-label drugs, and a "Moneyball" prescription for fixing modern medicine--by the author of Tripping Over the Truth
The United States is fast becoming the sickest nation in the Western world. Cancer rates continue to rise. There is an epidemic of chronic disease in children. Even with all the money and modern innovations in science, the country's health care system is beyond broken. Clearly there is a glitch in the system. But what if the solution has been here all along, and we've just been too blind to see it?
In Curable journalist and health care advocate Travis Christofferson looks at medicine through a magnifying glass and asks an important question: What if the roots of the current US health care crisis are psychological and systemic, perpetuated not just by corporate influence and the powers that be, but by you and me? It is now known that human perception is based on deeply entrenched patterns of irrational thought, which we attach ourselves to religiously. So how does this implicate the very scientific research and data that doctors rely on to successfully treat their patients?
A page-turning inquiry into a "moneyball approach to medicine," Curable explores the links between revolutionary baseball analytics; Nobel Prize-winning psychological research on confirmation bias; wildly successful maverick economic philosophy; the history of the radical mastectomy and the rise of the clinical trial; cutting edge treatments routinely overlooked by regulatory bodies; and outdated medical models that prioritize profit over prevention. As stark as things are, Christofferson asks us to see health care not as a toppling house of cards, but as a badly organized system that is inherently fixable. How do we fix it? First we must reframe the conflict between doctors' intuition and statistical data. Then we must design better systems that can support doctors who are increasingly overwhelmed with the complexity of modern medicine.
Curable outlines the future of medicine, detailing brilliant examples of new health care systems that prove we can do better. It turns out we have more control over our health (and happiness) than we think.
Never before have two revolutions with so much potential to save and prolong human life occurred simultaneously. The converging, synergistic power of the biochemical and digital revolutions now allows us to read every letter of life's code, create precisely targeted drugs to control it, and tailor their use to individual patients. Cancer, diabetes, Alzheimer's and countless other killers can be vanquished--if we make full use of the tools of modern drug design and allow doctors the use of modern data gathering and analytical tools when prescribing drugs to their patients. But Washington stands in the way, clinging to outdated drug-approval protocols developed decades ago during medicine's long battle with the infectious epidemics of the past. Peter Huber, an expert in science, technology, and public policy, demonstrates why Washington's one-size-fits-all drug policies can't deal with diseases rooted in the complex molecular diversity of human bodies. Washington is ill-equipped to handle the torrents of data that now propel the advance of molecular medicine and is reluctant to embrace the statistical methods of the digital age that can. Obsolete economic policies, often rationalized as cost-saving measures, stifle innovation and suppress investment in the medicine that can provide the best cures at the lowest cost. In the 1980s, an AIDS diagnosis was a death sentence, until the FDA loosened its throttling grip and began streamlining and accelerating approval of life-saving drugs. The Cure in the Code shows patients, doctors, investors, and policy makers what we must now do to capture the full life-saving and cost-saving potential of the revolution in molecular medicine. America has to choose. At stake for America is the power to lead the world in mastering the most free, fecund, competitive, dynamic, and intelligent natural resource on the planet--the molecular code that spawns human life and controls our health.
Andy Lazris, MD, is a practicing primary care physician who experiences the effects of Medicare policy on a daily basis. As a result, he believes that the way we care for our elderly has taken a wrong turn and that Medicare is complicit in creating the very problems it seeks to solve. Aging is not a disease to be cured; it is a life stage to be lived. Lazris argues that aggressive treatments cannot change that fact but only get in the way and decrease quality of life. Unfortunately, Medicare's payment structure and rules deprive the elderly of the chance to pursue less aggressive care, which often yields the most humane and effective results. Medicare encourages and will pay more readily for hospitalization than for palliative and home care. It encourages and pays for high-tech assaults on disease rather than for the primary care that can make a real difference in the lives of the elderly.Lazris offers straightforward solutions to ensure Medicare's solvency through sensible cost-effective plans that do not restrict patient choice or negate the doctor-patient relationship. Using both data and personal stories, he shows how Medicare needs to change in structure and purpose as the population ages, the physician pool becomes more specialized, and new medical technology becomes available. Curing Medicare demonstrates which medical interventions (medicines, tests, procedures) work and which can be harmful in many common conditions in the elderly; the harms and benefits of hospitalization; the current culture of long-term care; and how Medicare often promotes care that is ineffective, expensive, and contrary to what many elderly patients and their families really want.--Robert M. Duggan, author of Breaking the Iron Triangle: Reducing Health-Care Costs in Corporate America "Kirkus Reviews"
Even as humanity reels beneath the assault of AIDS, epidemiologists are gearing themselves up for the plague's successor. It might be dengue fever, whose carrier, the Asian tiger mosquito, has recently appeared in the United States, or Creutzfeldt-Jakob disease, which has been transmitted by contaminated human growth hormone. The next pandemic might be caused by any of a dozen viruses that were once confined to other species or territories but now place human beings at risk as we increasingly cross their boundaries.Updated to include the latest research and developments, this fascinating and sometimes unsetting book sums up all that we currently know about viruses: what they are, how they spread, and how scientists are trying to outwit them. Interweaving theory and real-life medical drama, A Dancing Matrix is science reportage at its most suspenseful and informative.
In today's world, it's easier than ever to move people, animals, and materials around the planet, but the same advances that make modern infrastructure so efficient have made epidemics and even pandemics nearly inevitable. And as outbreaks of COVID-19, Ebola, MERS, and Zika have demonstrated, we are woefully underprepared to deal with the fallout. So what can -- and must -- we do in order to protect ourselves from mankind's deadliest enemy?
Drawing on the latest medical science, case studies, policy research, and hard-earned epidemiological lessons, Deadliest Enemy explores the resources and programs we need to develop if we are to keep ourselves safe from infectious disease. The authors show how we could wake up to a reality in which many antibiotics no longer cure, bioterror is a certainty, and the threat of a disastrous influenza or coronavirus pandemic looms ever larger. Only by understanding the challenges we face can we prevent the unthinkable from becoming the inevitable. Deadliest Enemy is high scientific drama, a chronicle of medical mystery and discovery, a reality check, and a practical plan of action.
In this brilliant and gripping medical detective story. Richard Rhodes follows virus hunters on three continents as they track the emergence of a deadly new brain disease that first kills cannibals in New Guinea, then cattle and young people in Britain and France--and that has already been traced to food animals in the United States. In a new afterword for the paperback, Rhodes reports the latest US and worldwide developments of a burgeoning global threat.
"The raging debate over how to pay for health insurance has missed a profoundly important fact: As big as it is, as tight of a grip it has on American life, the health insurance industry is dying," states John Geyman, MD, in Do Not Resuscitate: Why the Health Insurance Industry is Dying, and How We Must Replace It. Written for lay readers, health care professionals, and policymakers alike, Do Not Resuscitate moves beyond books that decry our current problems to reveal what the trend for more than half a century of increasing costs and decreasing coverage really means. The situation for doctors, patients, caregivers, and even the insured will move from dysfunctional to a complete breakdown over the next decade. In one of many examples Geyman cites, as employers cut costs in a global economy, the cost of health insurance as a proportion of wages is rising to the point where it will consume all average household income by 2025.
While there have always been norms and customs around the use of drugs, explicit public policies--regulations, taxes, and prohibitions--designed to control drug abuse are a more recent phenomenon. Those policies sometimes have terrible side-effects: most prominently the development of criminal enterprises dealing in forbidden (or untaxed) drugs and the use of the profits of drug-dealing to finance insurgency and terrorism. Neither a drug-free world nor a world of free drugs seems to be on offer, leaving citizens and officials to face the age-old problem: What are we going to do about drugs?In Drugs and Drug Policy, three noted authorities survey the subject with exceptional clarity, in this addition to the acclaimed series, What Everyone Needs to Know�. They begin, by defining "drugs," examining how they work in the brain, discussing the nature of addiction, and exploring the damage they do to users. The book moves on to policy, answering questions about legalization, the role of criminal prohibitions, and the relative legal tolerance for alcohol and tobacco. The authors then dissect the illicit trade, from street dealers to the flow of money to the effect of catching kingpins, and show the precise nature of the relationship between drugs and crime. They examine treatment, both its effectiveness and the role of public policy, and discuss the beneficial effects of some abusable substances. Finally they move outward to look at the role of drugs in our foreign policy, their relationship to terrorism, and the ugly politics that surround the issue. Crisp, clear, and comprehensive, this is a handy and up-to-date overview of one of the most pressing topics in today's world. What Everyone Needs to Know� is a registered trademark of Oxford University Press.
In 1976 a deadly virus emerged from the Congo forest. As swiftly as it came, it disappeared, leaving no trace. Over the four decades since, Ebola has emerged sporadically, each time to devastating effect. It can kill up to 90 percent of its victims. In between these outbreaks, it is untraceable, hiding deep in the jungle. The search is on to find Ebola's elusive host animal. And until we find it, Ebola will continue to strike. Acclaimed science writer and explorer David Quammen first came near the virus while he was traveling in the jungles of Gabon, accompanied by local men whose village had been devastated by a recent outbreak. Here he tells the story of Ebola--its past, present, and its unknowable future.
Extracted from Spillover by David Quammen, updated and with additional material.
Driven by recent events and new trends, public health training increasingly requires new and more advanced information--leadership and management skills drawn from business, industry, education, and government. This text offers basic foundation for students entering the field of public health management with a specific focus on developing knowledge and skills in the cross cutting competency domains identified by the ASPH. Essentials of Management and Leadership in Public Health covers: An introduction and history of the field of public health management; The evolution of key leadership and management theories; The changing role of public health management professionals and key characteristics of a successful public health leaders; Key issues in the organization, financing and delivery of healthcare services; Fundamental concepts about the classic functions of management including economics, finance, marketing, strategy, administration, human resources, and community relations; and Modern approaches to leadership development, selection, retention and succession planning. Looking for more real-life evidence? Check out Cases 1, 2, 5-10, 13, 15, 19-21 in Essential Case Studies in Public Health, Putting Public Health into Practice.